INDIANAPOLIS (WISH) — A growing number of cities and counties in Indiana are suing opioid manufacturers and distributors, including several in Hamilton County.

Atlanta, Sheridan and Noblesville have all been working with Taft Stettinius & Hollister on the lawsuits. According to the law firm, Westfield is also in talks with them about the lawsuit.

Noblesville Mayor John Ditslear says they realized the opioid epidemic was becoming an issue for their city over the last several years.

“We’ve been prepared for this, it’s kind of crept up I think as a problem, but it is a major problem as I think we all know. For example, our EMS department has carried Narcan forever, for a long time since it’s been available. But our police department was equipped two years ago with Narcan because of the overdoses, drug overdoses. And so we have been able to save lives there, at least two years where we’ve been prepared and vision to do that, but it’s just grown,” he said.

The amount of Narcan the city EMS staff has administered over the last five years has doubled, according to James Macky, Division Chief of EMS.

“There’s more use. I see that on the end of ordering supplies, I’m ordering more Narcan than I ever have before. We also have dealt with Narcan shortages a couple years where we had a hard time getting Narcan and there was a big concern there that we wouldn’t be able to help people that needed Narcan,” said Macky.

The amount of deadly overdoses has also increased county-wide. According to the Hamilton County coroner, in 2014 there were 18 deadly overdoses, 21 in 2015, 26 in 2016 and 36 in 2017.

That’s one of the reasons why Noblesville is suing opioid manufacturers and distributors with the help of Taft Stettinius & Hollister.

“We believe that there is clear liability here, regarding both distributors and manufacturers, in their obligation to help fight the opioid crisis because in a large part it is of their making. They had obligations to those reports and that system that was set up, was designed specifically to prevent a black market and opioid crisis from being created and because they didn’t do that this is what we’re facing today,” said Chou-il Lee.

“We’ve seen this wreak havoc across the state with all of our clients. This isn’t unique to one client or one community, it truly affects everybody. With our work, we’ve seen this first hand, we’ve seen the hit on public safety officials in each of the communities is really the why of why we got involved,” said attorney Manny Herceg.

According to the lawsuit, filed on behalf of the Town of Sheridan, over the period of 2011-2015, the number of non-fatal emergency department visits due to opioid overdoses in Hamilton County has nearly doubled.

“This incredible harm, to not just the victims of opioid addition, but the communities in which those individuals lived, stems directly from the Defendants’ intentional choice to pump opoids into Plaintiff’s community in violation of state and federal law,” the lawsuit reads.

It goes on to say, “The distributors and manufacturers intentionally and/or unlawfully breached their legal duties under federal and state law to monitor, detect, investigate, refuse and report suspicious orders of prescription opiates. Despite the clear evidence before their eyes – that the number of opioids being sent into communities like Town of Sheridan could not be explained or justified by any conceivable medical need, but could only be explained by a flourishing and rapidly expanding black market for opioids — these wholesale distributors continued to push their substances into the community, willingly and knowingly becoming participates in the black market they were fueling.

The lawsuit also claims the manufacturers and distributors caused a financial burden on the cities for which they are seeking relief for costs for providing medical care, additional therapeutic and prescription drug purchases, and other treatments for patients suffering from opioid-related addiction or disease, including overdoses and deaths; costs for providing treatment, counseling, and rehabilitation services; costs for providing treatment of infants born with opioid-related medical conditions; costs associated with law enforcement and public safety relating to the opioid epidemic; and costs associated with providing care for children whose parents suffer from opioid-related disability or incapacitation.

“If no more, then bringing attention to our community about the seriousness of this epidemic. If it does become a class lawsuit, then maybe we reap something, but I think the most important thing is educating people on the severity of this and the burden it’s putting on all of us,” said Ditslear.

All of the manufacturers and distributors listed in the lawsuit responded to it with statements.

Responsibly used opioid-based pain medicines give doctors and patients important choices to help manage the debilitating effects of chronic pain. At the same time, we recognize opioid abuse and addiction is a serious public health issue that must be addressed.

We believe the allegations in the lawsuits against our company are both legally and factually unfounded. Janssen has acted in the best interests of patients and physicians with regard to its opioid pain medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label. According to independent surveillance data, Janssen opioid pain medicines consistently have some of the lowest rates of abuse among these medications, and since 2008 the volume of Janssen opioid products always has amounted to less than one percent of the total prescriptions written per year for opioid medications, including generics. Addressing opioid abuse will require collaboration among many stakeholders and we will continue to work with federal, state and local officials to support solutions.

-Jessica Castles Smith, spokesperson, Janssen Pharmaceuticals, Inc.

It is important to put into perspective Allergan’s role regarding opioids. Allergan’s two branded opioid products – Norco and Kadian – account for less than 0.08% of all opioid products prescribed in 2016 in the U.S. These products came to Allergan through legacy acquisitions and have not been promoted since 2012, in the case of Kadian, and since 2003, in the case of Norco. Allergan has a history of supporting — and continues to support — the safe, responsible use of prescription medications. This includes opioid medications, which when sold, prescribed and used responsibly, play an appropriate role in pain relief for millions of Americans.”

-ALLEGRAN Statement on Opioid Legal actions

AmerisourceBergen and other wholesale drug distributors are responsible for getting FDA-approved drugs from pharmaceutical manufacturers to DEA-registered pharmacies, based on prescriptions written by licensed doctors and health care providers. Our role in doing so is quite widespread across different therapies, with the distribution of opioid-based products constituting less than two percent of our sales.

We are dedicated to doing our part as a distributor to mitigate the diversion of these drugs without interfering with clinical decisions made by doctors, who interact directly with patients and decide what treatments are most appropriate for their care. Beyond our reporting and immediate halting of tens of thousands of potentially suspicious orders, we refuse service to customers we deem as a diversion risk and provide daily reports to the DEA that detail the quantity, type, and the receiving pharmacy of every single order of these products that we distribute. We are committed to collaborating with all stakeholders, including in Indiana, on ways to combat opioid abuse.

-AmerisourceBergen

Endo is dedicated to providing safe, quality products to patients in need and we share the public concern regarding opioid abuse and misuse. We are committed to working collaboratively to develop and implement a comprehensive solution to the opioid crisis, which is a complex problem with several causes that are difficult to disentangle. Any serious solution must therefore be multifaceted and consider, among other things, the legitimate access needs of the millions of patients suffering from acute or chronic pain who rely on opioids to improve their quality of life.

Toward that goal, Endo has taken meaningful action during the past year by voluntarily ceasing opioid promotion and eliminating its entire product salesforce. Endo also voluntarily withdrew Opana® ER from the market following FDA’s request despite having a statutory right to challenge that request, implemented additional anti-diversion measures and terminated its new opioid product development programs.

It is Endo’s policy not to comment on current litigation. That said, we deny the allegations contained in this lawsuit and intend to vigorously defend the Company.

– Endo

Teva is committed to the appropriate use of opioid medicines, and we recognize the critical public health issues impacting communities across the U.S. as a result of illegal drug use as well as the misuse and abuse of opioids that are available legally by prescription. To that end, we take a multi-faceted approach to this complex issue; we work to educate communities and healthcare providers on appropriate medicine use and prescribing, we comply closely with all relevant federal and state regulations regarding these medicines, and, through our R&D pipeline, we are developing non-opioid treatments that have the potential to bring relief to patients in chronic pain. Teva also collaborates closely with other stakeholders, including providers and prescribers, regulators, public health officials and patient advocates, to understand how to prevent prescription drug abuse without sacrificing patients’ needed access to pain medicine.”

-Teva

We are deeply troubled by the prescription and illicit opioid abuse crisis, and are dedicated to being part of the solution. As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge. Although our products account for approximately 2% of the total opioid prescriptions, as a company, we’ve distributed the CDC Guideline for Prescribing Opioids for Chronic Pain, developed three of the first four FDA-approved opioid medications with abuse-deterrent properties and partner with law enforcement to ensure access to naloxone. We vigorously deny these allegations and look forward to the opportunity to present our defense.”

-Purdue Pharma

As distributors, we understand the tragic impact the opioid epidemic has on communities across the country. We are deeply engaged in the issue and are taking our own steps to be part of the solution – but we aren’t willing to be scapegoats.

“Distributors are logistics companies that arrange for the safe and secure storage, transport, and delivery of medicines from manufacturers to pharmacies, hospitals, long-term care facilities, and others based on prescriptions from licensed physicians. We don’t make medicines, market medicines, prescribe medicines, or dispense them to consumers.

“Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated.

“We are ready to have a serious conversation about solving a complex problem and are eager to work with political leaders and all stakeholders in finding forward-looking solutions.”